Multidisciplinary interventions can enhance return-to-work for cancer patients

Clinical question: 
How effective are interventions aimed at enhancing return-to-work for cancer patients?
Bottom line: 
Four types of interventions were compared: psychological interventions, interventions aimed at physical functioning, medical interventions, and multidisciplinary interventions which incorporated physical, psychological and vocational components. No studies of vocational interventions aimed at work-related issues were retrieved. Moderate quality evidence showed multidisciplinary interventions involving physical, psychological and vocational components led to higher return-to-work rates than care as usual. No differences in the effect of psychological, physical, medical or multidisciplinary interventions compared with care as usual were found regarding quality of life outcomes.
The evidence regarding psychological, physical interventions or function-conserving medical interventions is limited, of low quality or inconclusive. The number of patients included in study analyses is generally low, with 11 studies providing fewer than 50 patients in each group thus limiting the power of the studies. In addition, 4 different types of interventions were considered and each type of intervention contained several subtypes of interventions. As a result, most subtypes of interventions only described 1 study, and meta-analyses for the subtypes of interventions were not possible. It was not possible to perform subgroup analyses according to diagnosis or quality of the study.
Cancer survivors are 1.4 times more likely to be unemployed than healthy people. It is therefore important to consider the value of programmes to support the return-to-work process for this patient group.
Review CD#: 
May, 2011
Authored by: 
Brian R McAvoy